The average cost of spinal fusion (fusing together two or more vertebrae so that they heal into a single, solid bone) in a hospital outpatient department is $764 with Medicare paying $611 and the patient paying $152. Does Medicare cover all types of back surgery?
Full Answer
Does Medicare cover spinal fusions?
Cervical Spinal Fusion No Complications. Wyoming. 74. $54481. $16013. $38468. Source: CMS. As part of the Obama administration’s goal to make our healthcare more accountable, transparent and affordable the CMS.gov has released data from more then 3000 hospitals that receive payments for the 100 highest frequently billed charges under Medicare.
How much does spinal fusion cost without insurance?
Nov 29, 2021 · If you don’t have health insurance coverage, be prepared to pay anywhere between $51,000 and $91,000 for this surgery. Also, if you don’t have health insurance and you must go through a spinal fusion in order to treat a fractured vertebra, a slipped vertebra, or other spinal problem, expect to pay $81,000 to more than $151,000.
How much will my back surgery cost?
Typical costs: For patients not covered by health insurance, a laminectomy, typically used to treat spinal stenosis [ 1] , a narrowing of the spine that occurs mostly in people over 50, typically costs $50,000 to $90,000. For patients not covered by health insurance, spinal fusion, typically used to treat conditions such as a slipped vertebra, fractured vertebra or other spinal instability, …
Does Medicare cover non-surgical treatment for chronic back pain?
Feb 12, 2019 · The average hospitalization was $27,182 per patient, with additional costs hitting $25,177 among patients aged 80 years or older. For patients younger than 65 years old, the additional costs reached $27,715. 2. Non-white Medicare beneficiaries incurred higher hospital costs than white beneficiaries, at $28,607 compared to $27,003. 3.
How much does spinal fusion cost?
For patients not covered by health insurance, spinal fusion, typically used to treat conditions such as a slipped vertebra, fractured vertebra or other spinal instability, typically costs $80,000 to $150,000 or more; a surgery in which high-end titanium implants are used instead typically will fall on the higher end.
How long does it take to recover from lumbar spine surgery?
The Mayo Clinic provides an overview of a laminectomy [ 4] and the North American Spine Society describes spinal fusion [ 5] . Most patients require two to six weeks of recovery time.
What is back surgery?
What should be included: Back surgery is used to correct a physical deformity -- either to take pressure off a nerve root or the spinal cord, to stabilize an unstable part of that back that is causing pain, or to fix a deformity such as scoliosos.
Does Medicare cover back surgery?
Medicare generally covers back surgery. For patients covered by insurance, assuming the deductible has been met, typical out-of-pocket costs would consist of coinsurance of between 10 and 40 percent of the procedure, for a total of $200 to $2,000 or more, up to the yearly out-of-pocket maximum.
How much does a laminectomy cost?
For patients not covered by health insurance, a laminectomy, typically used to treat spinal stenosis [ 1] , a narrowing of the spine that occurs mostly in people over 50, typically costs $50,000 to $90,000. For patients not covered by health insurance, spinal fusion, typically used to treat conditions such as a slipped vertebra, ...
How much does a back brace cost?
A back brace, which sometimes is required, can cost $200 or more . Physical therapy at $50 to $100 or more per session can add $1,000 or more to the cost. Pain medication probably will be prescribed during recovery, and sometimes equipment such as a walker, which can cost $50 to $100 or more, is needed. Discounts:
Is back surgery needed?
Back surgery, which is needed in only a small percentage of back pain cases, usually is recommended to be considered only when non-surgical treatments have failed to relieve symptoms and when the problem is caused by a pinched nerve, the spinal cord being compressed or excess movement between bones. Typical costs: ...
How long does spinal fusion surgery take?
What does the surgery involve? Spinal fusion surgery usually take between three and seven hours. You will be under general anaesthesia during the whole operation. The procedure may vary depending on the location of the vertebrae that need to be fused, as well as factors such as your general health and age.
What is the Medicare number for spinal surgery?
With Medicare, you can find spinal surgery items within sub-group 17 (spinal surgery) of group T8 (surgical operations) on the Medical Benefits Schedule (MBS). Item numbers 51011 to 51171 cover various spinal surgery operations, including spinal fusions. Costs vary depending on the surgery and surgeon but for a rough guide, item number 51013 has a fee of $2,430.55 with a benefit of 75%, meaning you could be looking at around $607.60 out of pocket for surgery fees.
Does Medicare cover spinal fusion?
Both Medicare and private health insurance can cover spinal fusion. Medicare can contribute towards 75% of the MBS fee for spinal surgery; health insurance can pay for the remaining 25%. We looked at over 30 policies and found basic and bronze ones that'll cover you for around $72 per month. Plan ahead and you can keep out ...
How long does it take to see a doctor?
Most policies come with a 2-month waiting period so you are able to see a doctor quickly. The waiting period goes up to 12 months if you have a pre-existing spinal condition. Hospital treatment with private health insurance for back, neck and spine usually covers the investigation and treatment of the back, neck and spinal column, ...
Why do you need a spinal fusion?
Metal plates are often used to hold the vertebrae together, so they can heal as one solid structure. You might need spinal fusion for: Spinal weaknesses. Your spine can become weak and unstable as a result of conditions such as severe arthritis in the spine or specific injuries. Herniated disk.
Does Medicare cover MBS?
Keep in mind though that your doctor doesn't need to adhere to the MBS fee. You might also have out-of-pocket expenses for anaesthesia fees, consultations, nursing fees and hospital fees. In some cases, Medicare will cover most of the costs which means you'll have very little out-of-pocket expenses.
Who is Gary Hunter?
Gary Hunter. Gary Hunter is a writer at Finder, specialising in insurance. He’s been writing about life, health, travel, home and pet insurance for over three years, has pored over hundreds of product disclosure statements and written more than 500 insurance articles.
What are the different types of back surgery?
The most common types of back surgery include the following: 1 Spinal fusion. If the spine is unstable or there is a deformity, permanently fusing damaged vertebrae with a bone graft and metal rods or plates can correct or improve the condition. 2 Laminectomy. Connective tissue between the vertebrae may be cut or removed in order to decompress the spine and relieve pressure on your spinal cord or nerves. This surgery is also used if the compression’s cause is related to other damages, such as the presence of a tumor, bone spur or disc fragment, which must be removed. 3 Discectomy. In conditions that involve herniated discs, the surgeon will remove any part of the disc that compresses nerves or the spinal column. 4 Artificial discs. Vertebral implants made with synthetic materials are sometimes used in place of spinal fusion but may not be suitable for all conditions that spinal fusion treats.
What happens if you have a spinal cord injury?
Due to the complexity of the spinal column, there is an elevated risk of experiencing paralysis, loss of control in the bladder or bowels, pain, weakness and sexual dysfunction if the spinal cord or surrounding nerves are damaged during surgery.
Can a surgeon remove a herniated disc?
In conditions that involve herniated discs, the surgeon will remove any part of the disc that compresses nerves or the spinal column. Artificial discs. Vertebral implants made with synthetic materials are sometimes used in place of spinal fusion but may not be suitable for all conditions that spinal fusion treats.
Is back surgery considered a major surgery?
Although many surgical procedures that relieve back pain can now be performed with minimally invasive procedures, it is still considered a major surgery. With any major surgery, there can be numerous risks. These risks include, but are not limited to, allergic reactions to anesthesia and other drugs, excessive bleeding, blood clots and infection. Certain people can be at a higher risk for a heart attack or stroke during surgery. Your surgical team should be aware of your medical history and any current medications you take in order to minimize risk.
Does Medicare cover back surgery?
Original Medicare Part A, also known as hospital insurance, provides coverage for inpatient hospital procedures, but Part B may also contribute to covering certain costs associated with back surgery.